Corticosteroids decrease pain, swelling and trismus.

DATA SOURCES: PubMed, Scopus, Medline and Cochrane Oral Health Group's Trials Register, CENTRAL. Limited to English language. STUDY SELECTION: Randomised control trials comparing preoperative steroids (in any formulation, dose or route) with placebo or no treatment in patients of any age, having extraction of one or more impacted third molars (under local or general anaesthesia or with intravenous sedation). DATA EXTRACTION AND SYNTHESIS: Two authors reviewed titles and abstracts of all articles to select those that met the inclusion criteria. The studies were classified by active principles, doses and treatment administration route. No meta-analysis was conducted and a tabular descriptive summary was presented. RESULTS: There were 28 studies (one meta-analysis and 27 randomised control trials) included in the descriptive account and from which conclusions were drawn. CONCLUSIONS: The use of corticosteroids in third molar extractions reduces the degree of trismus and inflammation. Parenteral administration seems to be more effective than oral administration as does taking the corticosteroids before rather than after surgery. Further comparative studies using different corticosteroids, doses and administration routes are needed to establish the most effective regime for reducing pain, trismus and inflammation after extraction of third molars.